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P�RMIT AI�R�.IC,ATIL�� '� <br /> CITY OF EVERETI' PERIIIIIT SERVICE5 <br /> I 3200 CEDAR STREET, EVERf_Tf, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 , <br /> (��� zb�l- �� � � <br /> I SITE ADD,RE�S I ` ,� ,. � P/,IiCEL TAX I.D.# PERMIT u � <br /> 1�') — ������� �� � �� ' ��� ��, � V <br /> �� --� 5C� - �-� � <br /> LEGAL LOTNO. BLOC��If, 7RACT t <br /> DESC. ���_i/� � C1 <br /> OWNEf� ADDRESS \ �� IP FHONE <br /> �' ���`�\ � ;���. . \���`�'����2y ����C �� � ` � �t ����1���3 <br /> TENANT�JAME CONT CT FOR PERMII � HONE <br /> �� � C ` v`�\��.. (������� -�� <br /> CONTRACTOR (\C �������.\\��� ADDRESS ZIP � CONTR.LIC[NSE# <br /> \ <br /> ( <br /> PHON '��- l ' ' � � ���`—� � ���� ��-���� ����� ����� <br /> PROPOSED USE UF BUILDING � uilding n MECh�nic21 , � Addi�Qn HEAT SOURCE <br /> I PERAIIT ombinalion � Plumbing WORK Alteratbn Electric <br /> T'!PE Demolition LJ Sic�n TYPE New � Gas <br /> Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORN. CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> (� -� � ,/ <br /> �J . A � 1� . ���'�/C. � � JQ <br /> PLUMBING MECHANICAL <br /> NO. I TYPE OF FIXTURE OR Il'EM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET NC—A/HANDLING UNITS <br /> yl BATHTUB � FORCED AIR SYSTEMS <br /> � LAVATORY (WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> \ KITCHFN SINK& DISPOSAL CLOTHES DRYER <br /> I DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY 1_ WATER HEATER <br /> _� CLOTHES�NASHER _ METAL FIREPLACC/STOVE <br /> URINAL _ FIREPLACF_ INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> = FLOOR DRAIN � GAS RANGE <br /> BACKFLOW PREVENTER (;AS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) <t— EXHAUST FAN <br /> OTHER � OTHER <br /> i <br /> I _ _ I <br /> I <br />�II �.� I HEREBY CERITIFY THAT I HAVfi RGAD AND EXAMI�JED THIS APPLICATION AND KNOW 7HE SAtdE TO BE TAUE AND COARECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 6E COMPLIED WITH IVHETHER SPECIFIED HEREIN OR <br /> . NOT. THE GRANTING OF A PERMIT DOES NOT PRFSUME TO GIVE AUTHORITY TO VIOLATE OR CAPd�F.L THE PROVISION OF ANY OTHER <br /> ' STATE OR LOCAL WW REGULATING COhSTRUCTION OR THE PEPFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8'/THE <br /> i OWNER OF THIS PROPERI"f TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> I ��CONTRACTO� F(SYA'�l 8. 7 RC`N AND 296.200 WAC. <br /> � �.�,� ,�F�����I�l�Q �-� � �l <br /> Signatur ol O� nContractovAuthonzed Agent Date <br /> � DEBIT & CREDIT CRRDS ARE NOT ACCEPTED <br /> I <br />